超声引导颈浅丛复合肌间沟单点或多点注药用于锁骨内固定术的效果分析

Effect of Single-Point and Multi-Point Injection in Superficial Cervical Plexus Combined with Interscalene of Clavicle Internal Fixation Guided by Ultrasound

目的比较超声引导下行颈浅丛复合肌间沟单点或者臂丛多点注药用于锁骨内固定术的麻醉效果。方法将46例择期行锁骨内固定术的患者随机分为单点注射组及多点注射组各23例。单点注射组在颈浅丛阻滞的基础上,臂丛上干给予0.5%罗哌卡因20 mL,多点注射组在多个神经干共给药20 mL。观察比较两组的操作时间、麻醉药起效时间、芬太尼的追加剂量、镇痛效果、不良反应以及综合满意度。结果多点注射组操作时间、不良反应发生率均高于单点注射组(P<0.05);两组麻醉药起效时间和芬太尼追加剂量比较差异不显著(P>0.05)。多点注射组的运动阻滞效果优于单点注射组(P<0.05)。结论与多点注射相比,颈浅丛复合臂丛上干单点注药舒适性更高,并发症更少。

Objective To compare the anesthetic effect of single-point and multi-point injection in superficial cervical plexus combined with interscalene of clavicle internal fixation guided by ultrasound. Methods 46 patients undergoing clavicle internal fixation were randomly and evenly divided into single-point injection （SP） group and multi-point injection （NIP） group. SP group was given 0.5% ropivacaine （20 mL） in upper brachial plexus based on superficial cervical plexus block, and MP group was given 0.5% ropivacaine （20 mL） in multiple neural trunk. The operation time, onset time, additional dosage of fentanyl, analgesic effect, adverse reactions and comprehensive satisfaction were observwd and compared. Results The operation time and adverse reactions rate in MP group were higher than those in SP group （P 〈0.05）; the onset time and additional dosage of fentanyl in the two groups had no statistical difference （P〉0.05）. The motor block effect of MP group was better than that of SP group （P 〈0.05）. Conclusions In contrast to multi-point injection, single-point injection in superficial cervical plexus combined with upper trunk ofbrachial plexus has higher comfort and fewer complications.